Progressive Life Changers

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PROGRESSIVE LIFE CHANGERS

Practice address

1101 Belleview St Ste 103
Columbia, SC 29201-1863

Phone

(704) 726-2590

Fax

(980) 422-0161

NPI assigned

Jun 28, 2017

Last updated

May 13, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth O'Bryan Curlee

Title

Owner

Phone

(704) 726-2590

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1760903918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BELLEVIEW ST STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011863",
            "telephone_number": "704-726-2590",
            "fax_number": "980-422-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BELLEVIEW ST STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011863",
            "telephone_number": "704-726-2590",
            "fax_number": "980-422-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE LIFE CHANGERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "CURLEE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "O'BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-726-2590"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7961",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@pglcinc.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1101 Belleview St Ste 103",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292011863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Columbia, SC
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.